Laurence Mikkel Johansen, MS, RD, CD
Dietitian, Registered in Elm Grove, WI. Individual provider (NPI-1).
NPI number1487841979
StatusActive
Last updated in NPPESSep 27, 2007
Details
- NPI
- 1487841979
- Entity type
- Individual (NPI-1)
- Name
- Laurence Mikkel Johansen
- Credential
- MS, RD, CD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 27, 2007
- Last updated
- Sep 27, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 2045-29 | WI | Yes |
| 133V00000X | Dietitian, Registered | 963363 | – |
Other names
- Larry Johansen (Professional Name)
Practice location
12425 Knoll RdSuite 110
Elm Grove, WI 53122-2657
Phone 262-780-9788
Mailing address
W137n6915 Manor Hills BlvdMenomonee Falls, WI 53051-5272
Phone 262-532-0293
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Other Registered Dietitian providers in Elm Grove, WI
- Erica Leigh Gutierrez, RDNNPI 1285495366
- Samantha Faye Kuspa, RDN, CD, LDNPI 1205349230
- Samantha Bauer Nutrition Therapy, LLCNPI 1215834718
- Annie Weiss, MS RD CEDSNPI 1548166945
All 5 Registered Dietitian providers in Elm Grove · All 279 providers in Elm Grove
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